AI That Takes Admin Off Your Claims Examiners
Carriers and TPAs lose examiner hours to file summaries, letters and diary notes. 12² builds file summaries, letter templates and a deadline tracker around the claims system.
Claims Examiner File Desk · From $4,500 + $349/mo, by team size · proposed estimate · It says it is an automated assistant whenever it talks to someone directly, and your team reviews what it drafts before it goes out.
Ai for insurance claims examiners: the short answer.
12² builds AI for carriers and TPAs that takes routine work off their claims examiners: summarizing claim file documents for review, drafting acknowledgment and status letters, drafting diary notes and tracking response dates. It runs inside the tools you already use. Licensed examiners make every coverage decision.
Sources
- General office-writing evidence, not a study of this job: in an RCT, ChatGPT cut professional writing time 40% and raised quality (Noy & Zhang, Science 2023)news.mit.edu
Research figures above describe the cited studies, not results 12² promises. Results vary. Disclosures
Where the hours go now.
Claim file documents
Carriers and TPAs lose examiner hours to file summaries, letters and diary notes.
Acknowledgment and status letters
Written up by hand, one at a time, after the real work is done.
Drafting diary notes from examiner inputs
Rebuilt from scratch each time, usually at the end of the day.
What it handles, and what it never does.
What it handles
- Claim file documentsIt summarizes claim file documents for examiner review.
- Acknowledgment and status lettersIt drafts acknowledgment and status letters.
- Drafting diary notes from examiner inputsIt drafts diary notes from examiner inputs.
- Statutory response datesIt tracks statutory response dates.
- Hand-off to your teamAnything that needs a person goes to the right person, with the details attached.
What it never does
- Make up a price or a factIt works only from the documents, records and price lists you give it. Anything it can't find goes to your team.
- Promise a resultQuestions about outcomes go to the person who does the work.
- Pretend to be a personIt says it is an automated assistant whenever it talks to someone directly.
- Make a credit, coverage or account decisionYour licensed staff make every one of those calls.
- Send anything on its ownDrafts wait for your team's approval before anything goes out.
Built and tested on your own work.
Before handoff, we run your build on your own real examples and fix anything that misses.
- Tested on your own workBefore handoff, we run your build on your own real examples and fix anything that misses.
- Retainer, then balance on deliveryRetainer up front. Work starts once the retainer is paid; the balance is due on delivery when the agreed test cases pass.
- Fixed price, scope and timelineAll three in writing before work starts. The timeline is set in your quote.
- What 12² buildsFile summaries, letter templates and a deadline tracker around the claims system.
- How it connectsWe confirm how it connects to your claims system on the first call and write it into your quote.
Related solutions: Claims & Policy Intake Desk · Underwriting File Prep Desk · Actuarial Report Drafting Desk · all solutions
See also: all industry packages · pricing
From $4,500 + $349/moSetup + monthly, by size. The monthly fee covers monitoring, fixes and re-tests for your package as your templates, documents and staff change. AI and software usage is billed at cost. Proposed starting estimates by team size, not fixed prices; the final price is in a written quote.
- Small: Small firm (1-10 staff)From $4,500 + $349/mo. The core build for 1-10 staff: file summaries, letter templates and a deadline tracker around the claims system. Proposed estimate. Small tier; monthly covers hosting, monitoring and fixes.
- Mid-size: Mid firm (11-50 staff)From $9,500 + $750/mo. Everything in Small firm, for more users, inboxes and calendars, with hand-off rules set for each role. Proposed estimate. More users, locations or integrations.
- Enterprise: Large firm / enterprise (50+ staff)From $25,000, custom quote. Everything in Mid firm, across locations or departments, with system integrations and a security review scoped in your custom quote. Proposed estimate floor; scope, integrations and security review set the final number. No cap.
- Retainer up front Work starts once the retainer is paid; the balance is due on delivery when the agreed test cases pass. Scope, price and timeline are agreed in writing before work starts.
- You own itThe accounts, scripts, templates and data sit in your name. You can leave at any time.
- Compliance and dataState insurance laws (unfair claims practices, data-security, producer licensing) apply; detail unverified per state. Licensed staff make every coverage, claim and pricing decision.
- Not professional advice12² is not an insurer, agency or adjuster, does not handle claims and does not perform licensed insurance activity. Coverage, claim and value decisions stay with your licensed staff. 12² builds software and automations. It is not a licensed professional in your field, and your team makes every professional decision. Disclosures
Straight answers.
Does AI decide coverage?
No. Licensed examiners decide; it summarizes and drafts.
How does payment work?
Retainer up front. Work starts once the retainer is paid; the balance is due on delivery when the agreed test cases pass.
How long does it take?
Timelines are set per project in the quote, after we see your systems and volume.
Are these prices final?
No. They are proposed starting estimates. You get a written custom quote after a short scoping call.
Tell us how you handle claim file documents now.
A few lines is enough. If it's a fit we'll say so, and if it isn't we'll tell you why.
- You'll hear back within one business day12² reads your note and replies about your project.
- A free 20-minute callHow the work runs now, what gets missed, and what your team needs from it.
- A fixed quoteYour size, scope, date and price in writing before any work starts.
Prefer email? Write to [email protected]
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